Families’ engagement in NICU care facilitates holding, skin-to-skin care, and human milk
feeding, which improve neonatal survival and long-term infant development. However, there are
many disproportionate structural barriers faced by marginalized families when visiting the NICU.
Few studies have characterized these structural barriers and evaluated how they affect infant
and parental disparities and outcomes. In this project, Dr. MK Quinn, hypothesizes that parents
of children in the NICU from marginalized backgrounds are less likely to have access to paid
family leave, childcare, transportation, and may encounter language barriers, and that this
contributes racial, ethnic, and socioeconomic disparities in preterm infant health outcomes.
This hypothesis will be addressed with two specific aims. First, to understand the barriers that
families face to engaging in the care of their preterm infants in mixed methods study Dr. Quinn
will identify barriers through key informant interviews of low-income families with preterm infants
in the NICU. This rich qualitative data of parents’ experiences will inform the development of
evidenced based theory of what is driving disparities in family visitation and engagement. This
will be followed by a multicenter survey of parents with preterm infants in the NICU, in order to
first understand the prevalence of these barriers and investigate how these barriers are
experienced by marginalized groups. Second, Dr. Quinn will conduct an observational study of
the health effects of the most salient barrier to care, paid family leave. For this analysis she will
investigate how the implementation of California’s paid family leave policy contributed to racial
and socioeconomic disparities in preterm infant care and outcomes.
The results of this study will provide the groundwork for designing policy interventions to ensure
families can engage in their preterm infant’s care, and ultimately, reduce inequities and improve
preterm health outcomes. The sponsor for this research is Dr. Henry Lee, a neonatologist with
expertise in health services research. The cosponsor, Dr. Jochen Profit, is a neonatologist with
expertise in neonatal inequities. The advisory team includes Dr. Maya Rossin-Slater, an
economist with expertise in family leave policy, Dr. Suzan Carmichael, an epidemiologist with
expertise in perinatal health inequities, and Dr. Christine Morton, a sociologist with expertise in
perinatal qualitative research. The research in this study in concert her training plan will provide
Dr. Quinn a foundation in the study of neonatal health inequities and prepare her for a career
continuing this research as an independent investigator.